MEDICARE: BAHAR ANBAR PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	PA02045	TX

General Provider Information

NPI Number	:	1548310691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BAHAR ANBAR PA

Provider Business Mailing Address
First Line	:	PO BOX 1322
Second Line	:
City	:	ADDISON
State	:	TX
Zip	:	75001-1322
Country	:	US
Telephone Number	:
Fax Number	:	972-991-4026

Provider Business Practice Location Address
First Line	:	1341 W MOCKINGBIRD LN
Second Line	:	MOCKINGBIRD TOWERS, STE 710E
City	:	DALLAS
State	:	TX
Zip	:	75247-6913
Country	:	US
Telephone Number	:	214-217-7520
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	07/17/2007

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Directions to “ BAHAR ANBAR PA” Practice Location

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